Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

Abstract

BackgroundAccess to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo.MethodsWe performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively.Results618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0-12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.92, 95% CI 0.51–1.67, p = 0.791).ConclusionsStrengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible.ClinicalTrials.gov, number NCT02626286 (December 10, 2015)https://clinicaltrials.gov/ct2/results?term=NCT02626286

HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis

“…As described above, five main outcomes were assessed: sexual risk behaviors ( n =14), 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 HIV incidence ( n =7), 18 , 20 , 21 , 23 , 24 , 26 , 32 HIV knowledge ( n =3), 29 , 33 , 34 social consequences of HIV status disclosure ( n =2), 31 , 33 linkage to referred facilities for HIV confirmatory testing ( n =1), 34 and mental health ( n =1). 18 Sexual risk behaviors were those associated with sex under the influence of a substance, unprotected sex (anal and/or vaginal), number of sex partners, HIV disclosure, and others.…”

“…As described in Table 2 , eight articles did not clarify the VCT-HIV protocol applied. 22 , 23 , 26 , 29 , 30 , 31 , 32 , 33 From the remaining articles, five cited a specific protocol that, when consulted online, was unavailable. 20 , 21 , 24 , 25 , 34 We contacted the authors to have access to unpublished data, which was eventually unsuccessful.…”

“…As described above, five main outcomes were assessed: sexual risk behaviors (n=14), 18−31 HIV incidence (n=7), 18,20,21,23,24,26,32 HIV knowledge (n=3), 29,33,34 social consequences of HIV status disclosure (n=2), 31,33 linkage to referred facilities for HIV confirmatory testing (n=1), 34 and mental health (n=1). 18 Sexual risk behaviors were those associated with sex under the influence of a substance, unprotected sex (anal and/or vaginal), number of sex partners, HIV disclosure, and others.…”